Canadians Widely Unaware Of How To Protect Against Travellers' Diarrhea Caused By An E. Coli Infection

Ninety-four per cent of Canadians are unaware they can get sick from contaminated ice cubes while on vacation¹

TORONTO, Oct. 7, 2014 /CNW/ - Planning for warmer climates this travel season? Why spoil the fun? Up to 70 per cent of travellers may experience travellers' diarrhea while on vacation, the most common travel-related disease. However, a recent survey has revealed the majority of Canadians (79%) are not as travel savvy as they should be about the potential causes, symptoms and risks of an E. coli infection.^2,3,4 Bacterial pathogens, such as enterotoxigenic E. coli (ETEC), are thought to cause approximately 80 per cent of cases of travellers' diarrhea, which is characterized by a sudden onset of symptoms including watery diarrhea, fever, nausea, vomiting, and abdominal pain.^5,6 ETEC is the leading bacteria causing up to one third of travellers' diarrhea cases.⁷

"The effects of travellers' diarrhea can be very serious, especially for children and older adults," says Dr. Richard Fedorak, President of the Canadian Digestive Health Foundation. "Diarrhea caused by an E.coli infection is uncomfortable, inconvenient and can lead to severe dehydration which can be life-threatening. Knowing how to manage food and water intake, being sure to wash your hands before eating, and taking preventative measures, such as medications prior to leaving for your vacation, can all help protect you and your holiday."

Contracting travellers' diarrhea caused by ETEC infection while on vacation can have a considerable personal and financial impact. Of those affected by the illness, up to one in five are bed-ridden for an entire day, and symptoms can last up to seven days.^8,9 Despite the impact an infection can have, the survey revealed that Canadians rank researching over-the-counter medications "just in case" as a higher priority than talking to a healthcare professional about preventative measures – such as travel vaccinations.¹⁰   

"Many patients consider purchasing over-the-counter medications to manage travellers' diarrhea in case it happens when travelling abroad, yet they don't always think about protecting themselves before they leave for vacation," said Tommy Cheung, pharmacist at Enhanced Care Medical Clinic, a multidisciplinary clinic based in Toronto. "DUKORAL^® is a drinkable vaccine that can help prevent travellers' diarrhea caused by ETEC for about three months, so travellers can take it before their vacation. It's available through the pharmacy without a prescription."

Canadians are likely to make food and beverage mistakes while on vacation
ETEC is a bacteria transmitted by contaminated food and water.¹¹ Sources can include undercooked meat or fish, fresh salads, raw vegetables, unpeeled fruit, cold sauces, unpasteurized dairy products and untreated water or ice cubes.¹² The E. coli Insurance Survey reveals that Canadians lack knowledge and understanding of the implications of ETEC infections associated with travel.

According to the survey:¹³

• Ninety-four per cent of people didn't know they could get an E. coli infection from contaminated ice cubes while on vacation
• Ninety-six per cent didn't know they could contract an E. coli infection from raw fruits and uncooked vegetables while on vacation
• Eighty-six per cent didn't know they could contract an E. coli infection from improperly cooked beef while on vacation
• Sixty-seven per cent didn't know they could contract an E. coli infection from contaminated drinking water or drinking from a contaminated glass while on vacation

The Checks and Balances of ETEC Infections
More than one quarter of Canadian travellers surveyed report that after creating a travel "to-do" list, getting travel insurance is the most important priority when preparing for a vacation. However, they don't always consider talking to a healthcare professional about travel vaccinations, such as protection against travellers' diarrhea caused by ETEC.¹⁴

Remember the following when travelling:

• Drinking bottled water is generally recommended to cut the risk of consuming ETEC bacteria.¹⁵ But just because water is in a bottle, doesn't mean that it hasn't been filled up at a tap. As a precaution, make sure the bottle is factory-sealed to guarantee that it is safe to drink.¹⁶ 
• No food group can be regarded as "safe" from transmitting the bacteria that can cause travellers' diarrhea. Food may stand for several hours at room temperature, allowing bacteria to multiply.¹⁷ It may become contaminated by food handlers or the environment before being consumed. The general rule of thumb is to "cook it, boil it, peel it or leave it" when consuming fruit or vegetables.¹⁸ 
• Travellers' diarrhea caused by ETEC infection can be prevented. The Canadian government recommends consulting a healthcare provider six weeks before you travel.¹⁹ Canadians planning a vacation should talk to their pharmacist or other healthcare provider about prevention and treatment options for travellers' diarrhea, including DUKORAL^®.²⁰

About DUKORAL^®
DUKORAL^® is indicated for the prevention of and protection against travellers' diarrhea and/or cholera in adults and children two years of age and older who will be visiting areas where there is a risk of contracting travellers' diarrhea caused by ETEC, or cholera caused by V. cholera.²¹ DUKORAL ^® is a vaccine that you drink, and it is available from a pharmacist without a prescription for protection against travellers' diarrhea. It is the only oral vaccine that protects against travellers' diarrhea and the first dose is taken at least two weeks before departure for about three months of protection.²² A single booster dose of DUKORAL ^® will renew protection against travellers' diarrhea if the last dose was taken in the preceding three months to five years. A single-dose DUKORAL ^® format is available from the pharmacy, and should be taken at least one week before travelling.²³

Important Safety Information
DUKORAL^® is intended to help prevent travellers' diarrhea caused by ETEC and/or cholera in adults and children two years of age and older. It does not treat travellers' diarrhea once it develops. Not everyone who gets vaccinated will be fully protected; therefore, precautions to avoid contaminated food or water should be taken. Side effects may include gastrointestinal upsets, such as abdominal pain, diarrhea, nausea or vomiting, and allergic reactions may occur. Please refer to the DUKORAL^® Product Monograph for additional safety information and for complete prescribing information, available at www.janssen.com.

About Janssen Inc.
Janssen Inc. is one of the Janssen Pharmaceutical Companies, which are dedicated to addressing and solving some of the most important unmet medical needs in oncology, immunology, neuroscience, infectious diseases and vaccines, and cardiovascular and metabolic diseases. Driven by our commitment to patients, we bring innovative products, services and solutions to people throughout the world. Please visit www.janssen.ca for more information.

About the Survey
The E. coli Insurance Survey was conducted by Instar Research and commissioned by Janssen Inc. to examine experiences and attitudes about travel health and E. coli.²⁴ The data was fielded between August 13 and 20, 2014 and included an online poll of 507 Canadians who were asked 11 questions. The precision of Instar Research online polls is measured using a credibility interval. In this case, the survey is accurate to within +/- 4.4 percentage points had all Canadian adults been surveyed.

Tommy Cheung was not compensated for participating in media relations related to DUKORAL^®. He has been a paid consultant to Janssen Inc.

*All trademark rights used under license.

References:
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¹ E. Coli Insurance Report. Instar Research. August 2014. Slide 10
² Conner, BA. Chapter 2: Travellers' Diarrhea. In: Brunette GW, Kowarsky PE, et al. CDC Health Information for International Travel : The Yellow Book. New York, NY : Oxford University Press; 2013. Available from: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-2-the-pre-travel-consultation/travelers-diarrhea
³ Kollaritsch H1, et al Traveller's Diarrhea. Infect Dis Clin North Am. 2012 Sep;26(3):691-706
⁴ E. Coli Insurance Report. Instar Research. August 2014. Slide 10
⁵ Centers for Disease Control and Prevention. Travellers' Diarrhea. Accessed September 2014. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/travelersdiarrhea_g.htm.
⁶ Public Health Agency of Canada.  Escherichia coli. Pathogen Safety Data Sheet. Accessed September 2014. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/escherichia-coli-tox-eng.php.
⁷ Kollaritsch H1, et al Traveller's Diarrhea. Infect Dis Clin North Am. 2012 Sep;26(3):691-706
⁸ Yates, Johnnie, M.D, Am Fam Physician. 2005 Jun 1;71(11):2095-2100. Accessed September 2014. http://www.aafp.org/afp/2005/0601/p2095.html.
⁹ Public Health Agency of Canada.  Escherichia coli. Pathogen Safety Data Sheet. Accessed September 2014. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/escherichia-coli-tox-eng.php.
¹⁰ E. Coli Insurance Report. Instar Research. August 2014. Slide 7
¹¹ Public Health Agency of Canada.  Escherichia coli. Pathogen Safety Data Sheet. Accessed September 2014. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/escherichia-coli-tox-eng.php.
¹² Public Health Agency of Canada.  Escherichia coli. Pathogen Safety Data Sheet. Accessed September 2014. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/escherichia-coli-tox-eng.php.
¹³ E. Coli Insurance Report. Instar Research. August 2014. Slide 10
¹⁴ E. Coli Insurance Report. Instar Research. August 2014. Slide 7
¹⁵ Government of Canada. Eat and Drink Safely. Accessed September 2014. http://travel.gc.ca/travelling/health-safety/food-water
¹⁶ Government of Canada. Eat and Drink Safely. Accessed September 2014. http://travel.gc.ca/travelling/health-safety/food-water
¹⁷ Government of Canada. Eat and Drink Safely. Accessed September 2014. http://travel.gc.ca/travelling/health-safety/food-water
¹⁸ Government of Canada. Eat and Drink Safely. Accessed September 2014. http://travel.gc.ca/travelling/health-safety/food-water
¹⁹ Government of Canada, Travel.gc.ca.  Travellers' Diarrhea.  Accessed September 2014.  http://www.phac-aspc.gc.ca/tmp-pmv/info/diarrhea-eng.php
²⁰ NAPRA Drug Scheduling – DUKORAL^® Vaccine.
²¹ DUKORAL^® Product Monograph 2012.
²² DUKORAL^® Product Monograph 2012.
²³ DUKORAL^® Product Monograph 2012.
²⁴ E. Coli Insurance Report. Instar Research. August 2014. Slide 2

SOURCE: Janssen Inc.

Jennifer McCormack, Janssen Inc., 416-449-9444, [email protected]; Amanda Federchuk, GCI Group, 416-486-7231, [email protected]